Efodyl Cefuroxim 250mg Merap Efodyl Cefurox 250mg Treatment (20 packs)

Pharmacokology

Pharmacological Group: Cephalosporin Antibiotics 2

ATC code: J01DC02

Mechanism of action

Cefuroxime acetyl is a precursor, has no antibacterial effect, into the body hydrolyzed under the effect of enzyme esterase into cefuroxime to work. Cefuroxime has the effect of killing bacteria in the stage of growth and division by inhibiting the synthesis of bacterial cells. The drug is attached to proteins attached to penicillin (penicillin binding protein, PBP), which are proteins involved in the composition of bacterial cell membrane structure, acting as a catalytic enzyme for the final stage of the cell synthesis process. As a result, the synthetic cell wall will be weakened and not. Under the impact of osmotic pressure. The affinity associated with Cefuroxime with PBP of different types will be the drug effect.

Medicine resistance mechanism

Cefuroxim resistant bacteria may be due to one or more mechanisms:

The percentage of drug resistance depends on geography and time for certain bacteria. Information about local drug resistance is very important, especially in the treatment of serious infections.

cefuroxim usually has in vitro activity for the following bacteria:

sensitive bacteria

Staphylococcus aerate aerobic gramic bacteria (methicillin sensitivity), Staphylococcus does not give birth to coagulase (sensitive to methicillin), Streptococcus pyogenes, Streptococcus agalactiae

Aerobic gram -negative bacteria: Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella CatVrhalis.

Bacteria: Borrelia Burgdorferi.

Bacteria may have problems due to anti -drug resistance:

Aerobic Gram -positive bacteria: Streptococcus pneumonia enzymes

Aerobic gram -negative bacteria: Citrobacter Freundii, Enerobacter Aerogenes, Entobacter Clacae, Escherichia Coli, Klebsiella Pneumonia, Proteus Mirabilis, Proteus spp. (excluding P Vulgaris), Providencia spp.

Anaerobic gram -positive bacteria: peptostreptococcus spp., Propionibacterium spp.

Anaerobic gram bacteria: Fusobacterium spp., Bacteroides spp.

Bacteria that have been resistant to drugs

Aerobic grams: Enterococcus Faecalis, Enterococcus Faecium.

anaerobic gram: bacteroides fragilis.

All S. Aureus strains are resistant to methicillin are resistant to cefuroxime.

Pharmacokinetics

Absorb

After taking Cefuroxime Acetil, it is absorbed from the stomach - intestine and is quickly hydrolyzed in the intestinal mucosa and the Cefuroxime release sample in the body's circulatory cycle.

The best absorbed drug when taken immediately after eating. The absorption rate of cefuroxime from the chewed chaos is reduced compared to the tablet form, which leads to lower serum peak concentration, the peak time is slower and reduces the bioavailability of the body (lower than 4 to 17%).

Distribution

The protein mounting ratio is recorded different, between 33 to 50%, depending on the method of use. After taking a dose of Cefuroxime Acetil 500 mg in 12 healthy vows, the apparent distribution of 50 liters (CV% = 28%). Cefuroxime concentration exceeds the minimum inhibitor for common pathogens that can be achieved in tonsils, sinuses, bronchial mucosa, bones, pleura fluid, joint fluid, interstitial fluid, bile, sputum and aquarium. Cefuroxime passes through the blood-flabby barrier when the meninges are inflamed.

Metabolism

cefuroxime is not metabolized.

Elimination

Serum disposal time is from 1 to 1.5 hours. Cefuroxime is excreted through the renal tubules and glomerular filtration. The clearance of the kidney is between 125 to 148 ml/min/1.73 m2.

Special patients

Gender

There is no difference in pharmacokinetics of Cefuroxime observed on men and women.

Elderly

There is no special warning in elderly patients with normal kidney function with a maximum dose of 1 g/day. Elderly patients are often at risk of renal function, so the dosage should be adjusted in accordance with the kidney function in the elderly.

Children

In newborns greater than 3 months old and children, the pharmacokinetics of Cefuroxime are similar to adults. There is no clinical test data on the use of cefuroxime acetyl in infants under 3 months of age.

kidney failure

Safety and effectiveness of cefuroxime acetyl in patients with renal failure has not been set.

cefuroxime is mainly excreted by the kidneys. Therefore, as with other antibiotics, in patients with a significant impaired renal function (CLCR

Hepatic failure

There is no data in patients with liver failure. Because Cefuroxime is mainly excreted through the kidneys, the impaired liver function is expected to not affect the pharmacokinetics of Cefuroxime.

Mobile pharmacokinetic/pharmacokinetic correlation

As cephalosporin antibiotics, the most important pharmacokinetics - pharmacokinetic index with in vivo is recorded as the percentage of the time between the two giving drugs (%T), the concentration of free drugs is higher than the minimum inhibitory concentration (MIC) of Cefuroxime with each specific bacteria strain (%T> MIC).

Adults and children> 40 kg

Be cautious when using

Hypersensitivity reaction

It is necessary to be prudent especially for patients with a history of allergic reactions to penicillin or other betalactam antibiotics because of the risk of cross -reaction.

Like all betalactam antibiotics, serious hypersensitivity reactions and sometimes death have been reported. In case of serious hypersensitivity reactions, Cefuroxime must be discontinued and must take appropriate emergency measures. Before starting treatment, it is necessary to determine if the patient has a history of hypersensitivity to cefuroxime, cephalosporin or any other betalactam antibiotic. Caution should be used when using cefuroxime for patients with a history of severe hypersensitivity to other betalactam drugs.

Jarisch-HERXHEIMER reaction

Has the Jarisch-HERXHEIMER reaction after taking Cefuroxime Acetil in the treatment of Lyme disease. It is a direct result from the bactericidal activity of Cefuroxime Acetyl for Lyme pathogenic bacteria, Borrelia Burgdorferi. Patients should be known that this reaction is a common consequence and often recovered from the treatment of Lyme with antibiotics (see the unwanted effect).

Excessive development of non -sensitive microorganisms. Like other antibiotics, the use of cefuroxime acetyl can lead to over -development of Candida. Long -term use can lead to excessive growth of other non -sensitive microorganisms (for example, Enterococci and Clostridium difficile), may need to interrupt the treatment.

Colitis and fake colitis are found in most antibiotics including cefuroxime and can fluctuate in mild to life -threatening levels. Therefore, this diagnosis is considered in patients with diarrhea during or after using Cefuroxime. Discontinue treatment with cefuroxime and specific treatment for Closfridium difficile should be considered. Do not use intestinal inhibitors.

affect diagnostic tests

The use of Cefuroxime is related to positive Coombs tests that can affect diagonal blood reactions because fake negative results may occur when using Ferricyanide tests, so the method of glucose oxidase or hexokinase is recommended to determine blood/plasma glucose/plasma concentration in patients using EFILYL nuggets.

Caution information about excipients

Sucrose, sucralose: Patients with rare genetic problems such as galactose intolerance, Nap fructose, lactase deficiency, Glucose-Galactose or Sucrase-Isomaltase Should not take this drug.

The effect of the drug on the ability to drive and operate machinery

The drug is likely to cause headaches, dizziness, should not drive or operate machinery while using the drug.

Use drugs for women during pregnancy and lactation

Pregnancy

There are very little data from the use of cefuroxime in pregnant women. Animal studies show that there is no harmful effects on pregnant women, fetal development, childbirth or the development of babies after birth. Efodyl should only be indicated for pregnant women when benefits exceed risk.

Breastfeeding period

cefuroxime is excreted in breast milk in small quantities. Unwanted effects in the treatment dose do not usually occur, although it is not possible to eliminate the risk of diarrhea and mucosal fungal infection. Efodyl should only be used during breastfeeding after evaluating risk benefits.

Interactive drug

Medicines that reduce gastric acid can reduce the bioavailability of cefuroxime acetyl compared to biochemistry when hungry and tend to lose strength to strengthen after meals.

Cefuroxime Acetyl can affect the bacterial system, leading to reducing the reabsorption of the estrogen and reducing the effectiveness of oral contraceptives used in combination.

Probenecid is simultaneously reducing the clearance of Cefuroxime in the kidney, increasing the meaning of the peak concentration, the area of ​​the curve and the sale time of Cefuroxime.

Simultaneous use of cefuroxime with aminoglycosides or strong diuretics (such as Furosernide) may increase the likelihood of kidney toxicity.

Simultaneous use with oral anticoagulants can increase the INR.